Abstract
To check if any biomarker can be useful to assess Community Acquired Pneumonia (CAP) severity, we studied white blood cells count (WBC), and levels of C Reactive Protein (CRP), Procalcitonin (PCT) and Proadrenomedullin (MR-proADM), as well as PSI and CURB65 scores from 228 patients with CAP, within the first 24 hours of their admission in our hospital.
MR-proADM correlated better with both severity scores than other biomarkers, and was the only biomarker able to distinguish among all different risk classes of PSI score (p<0.05 for every of the two groups comparisons, see figure 1 and 2).
ROC analysis for discrimination between low risk (PSI 1-3) from high risk (PSI 4-5) CAP showed that MR-proADM had the best AUC (0.811). and could be considered a good predictor of CAP severity (see figure 1 and table 1).
Optimal cut-off of MR-proADM of 0.646 nmol/L showed a sensitivity of 92.1%, specificity 55.1%, positive predictive value 76.2%, and negative predictive value 80.3% for severe CAP.
MR-proADM can be helpful, together with validated clinical scores, to identify CAP severity in the first hours of patient's management.
- © 2011 ERS